lipid digestion & absorption
TRANSCRIPT
Lipid Digestion Lipid Digestion
& &
AbsorptionAbsorptionAbsorptionAbsorption
Dr Dr PiyushPiyush B. TailorB. Tailor
Assistant ProfessorAssistant Professor
Clinical Clinical Biochemistry DepartmentBiochemistry Department
Govt. Medical CollegeGovt. Medical College
SuratSurat
Digestion of lipids
� The major dietary lipids
�Triacylglycerol
�Cholesterol
�Phospholipids.�Phospholipids.
� Indian diet = 20-30 gm of lipids per
day.
Digestion in stomach
• The lingual lipase from the mouth enters stomach along with the food.
• Optimum pH of 2.5 – 5.
• The enzyme therefore continues to be active • The enzyme therefore continues to be active in the stomach.
• Acts on short chain triglycerides (SCT).
• SCTs are present in milk, butter and ghee.
• Gastric lipase is acid stable
• with an optimum pH about 5.4 .
• It is secreted by Chief cells, the
secretion is stimulated by Gastrin.secretion is stimulated by Gastrin.
• Up to 30% digestion of triglycerides
occurs in stomach.
Digestion in intestine
• Emulsification is pre-requisite for
digestion of lipids.
• smaller droplets
• surface tension is reduced• surface tension is reduced
• surface area of droplets is increased.
• This process is favoured by:
1. Bile salts (Detergent action)
2. Peristalsis (mechanical mixing)
3. Phospholipids
Bile salts are important for digestion of
lipids
• sodium glycocholate
• sodium taurocholate)
• lower surface tension .• lower surface tension .
• Emulsify the fat droplets.
• Increases the surface area of the
particles for enhanced activity of
enzymes.
Action of Bile Salts
• The hydrophobic portions of bile salts
intercalate into the large aggregated lipid,
with the hydrophilic domains remaining
at the surface.
• This leads to breakdown of large
aggregates into smaller droplets.
• Thus the surface area for action of lipase
is increased.
Lipolytic enzymes in intestine
1. Pancreatic lipase with co-lipase.
2. Cholesterol esterase.
3. Phospholipase A2.3. Phospholipase A2.
• The bile (pH 7.7)
– Neutralise the acid of the stomach
– Provides favourable pH.
– Action of pancreatic enzymes occur.
Digestion of triglycerides
1. Pancreatic lipase
1. Hydrolyses to 1st and 3rd carbon atoms of glycerol
2. Form
1. 2-monoacyl glycerol
2. Two fatty acid.2. Two fatty acid.
2. Isomerase shifts FA position 2 to 1.
3. Than 1st position is then hydrolysed by
lipase to form free glycerol and fatty
acid.
3. Major end product
• 2-MAG (78%)
• 1-MAG(6%)
• Glycerol and fatty acids (14%).
• Thus digestion of TAG is partial • Thus digestion of TAG is partial
(incomplete).
4. Cholesterol ester
• free cholesterol and fatty acids.
5. Phospholipase A2
• Lysophospholipid and fatty acid.
Co-lipase
• Bind to the triacylglycerol molecules at the
oil water interface is obligatory for the action
of lipase.
• Secreted by the pancreas as zymogen.• Secreted by the pancreas as zymogen.
• It is activated by trypsin.
Fat globulelecithin
Bile salt
Hydrophobic region
Emulsification droplets
Free fatty acid
monoglyceride
Pancreatic lipase
Hydrophilic region
Pancreatic lipase
lecithin
Fat globule is broken up by lecithin and salts
monoglyceride
Free fatty acidtriglyceride
monoglyceride
Free fatty acid
cholesterol
Fat-soluble vitamins
Lipid core
Micelles
Anatomy and Physiology, Saladin
Bile salt
Dietary lipid
Absorption of lipids1. Mixed micelle formation:
• 2-monoglycerides, long chain fatty acids, cholesterol, phospholipids and lysophospholipids are incorporated into molecular aggregates to form mixed micelle.
• The micelles are spherical particles with a • The micelles are spherical particles with a hydrophilic exterior and hydrophobic interior core .
• Due to their detergent action , the bile salts help to form micellar aggregates.
2. Micellar is essential for the absorption of
fat soluble vitamins A, D and K.
3. The micelles are aligned at the
microvillous surface of the jejunal
mucosa.
4. Fatty acids, 2-MAG and other digested 4. Fatty acids, 2-MAG and other digested
products passively diffuse into the
mucosal cell.
2. Enterohepatic circulation of Bile Salts
• The bile salts are reabsorbed from the ileum
and returned to the liver to be re-excreted .
• About 98 % of dietary lipids are normally
absorbed.absorbed.
3. Re – esterification inside mucosal cell
1. Inside the intestinal mucosal cell
– Long chain fatty acids are re-esterified to form
triglyceride.
2. The fatty acids are first activated2. The fatty acids are first activated
– to Fatty acyl CoA by the enzyme
– Acyl CoA synthetase or thiokinase.
– This needs lysis of two high energy bonds.
3. Two such activated fatty acids react with
mono acyl glycerol (MAG) to form the
triglyceride.
4. Free glycerol absorbed from intestinal
lumen directly. lumen directly.
So free glycerol is not available for re-
esterification.
But the cells can convert glucose to
glycerol phosphate, and synthesise TAG.
4. Chylomicrons
• Incorporated into Chylomicrons
– Triacylglycerol
– Cholesterol ester
– Phospholipids
– Apo protein B48 and apo-A– Apo protein B48 and apo-A
• The chyle (milky fluid) from the intestinal
mucosal cells loaded with Chylomicrons are
transported through the lacteals into the
thoracic duct and then emptied into lymph
circulation.
• Serum may appear milky after a
high fat meal due to the presence of
Chylomicrons in circulation .
• Normally the lipemia clears within a • Normally the lipemia clears within a
few hours by the uptake of
Chylomicrons by tissues.
5. Short chain fatty acid absorption is
different
• SCF = Milk , Butter, Ghee
• MCF = Coconut oil and mother’s milk
• Do not need re-esterification.
• Directly enter into blood vessels, then to
portal vein, finally to liver where they are
immediately utilised for energy.
• Their absorption is rapid.
• They are better absorbed than long chain
fatty acids.
Abnormalities in Absorption of lipids
1. Defective digestion:
– Steatorrhea = daily excretion of fat in faeces is
> 6 gm per day.
– In pancreatic diseases = split steatorrhea.
2. Defective absorption:2. Defective absorption:
– if the absorption is also defective , most of the fat
in stools may be split fat.
– Gall bladder obstruction = Unsplit
steatorrhea
Defective absorption may be due to diseases:
1. Coeliac disease, Sprue, Crohn’s disease.
2. Surgical removal of intestine.
3. Obstruction of bile duct:
1. Gallstones
2. Tumours of head of pancreas
3. Enlarged lymph glands
In such cases, triglycerides with short chain and medium
chain fatty acids are digested and absorbed properly.
because they do not required micellerisation for
absorption.
Since milk fat and coconut oil are made up of MCT, they
are therapeutically useful in malabsorption syndromes.
Chyluria
• There is an abnormal connection between the urinary tract and lymphatic drainage system of the intestine. Urine appears milky due to lipid droplets.
Chylothorax
• can result from an abnormal connection between the pleural cavity and thoracic duct.
Fate of Chylomicrons
1. The absorbed (exogenous) triglycerides are transported in blood as Chylomicrons. They are taken up by adipose tissues and liver.
2. Liver synthesises endogenous triglycerides. These are transported as VLDL and are These are transported as VLDL and are deposited in adipose tissue.
3. During starvation states, triglycerides in adipose tissue are hydrolysed to produce free fatty acids . In the blood, they are transported, complexed with albumin. These free fatty acids are taken up by the cells and are then oxidised to get energy .